How to manage stage G3pT2 bladder cancer for my dad at 72?

Question

Hi doctor,

My father, who is 72, was diagnosed with a bladder tumor a month ago when he went to the local doctor for the treatment of blood drops in the urine. I have attached the diagnosis report for your reference. The doctors advised to operate on it as soon as possible, and the operation took place 10 days ago.

The biopsy report says high-grade transitional cell carcinoma of stage G3pT2. I have attached the report for your reference. Could you please advise on the next step of the treatment? Please let me know if you require additional information that I have not provided in this case. Your help would be highly appreciated.

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

This report (attachment removed to protect patient identity) of high-grade TCC (transitional cell carcinoma) with a large tumor with muscle invasion is not a good tumor. At this stage, we need to do a metastatic evaluation to rule out any distant spread of this tumor. Hoping that it turns out to be non-metastatic and he is in good general health, the best option will be to do a radical cystectomy with urinary diversion.

I advise you to do the following investigations;

Liver function test.
Chest x-ray.

If anything suspicious, further imaging, like a bone scan or chest CT. May also undergo PET-CT instead to evaluate for metastasis.

The most common diversion performed is an ileal conduit to form a urinary collection pouch out of a segment of intestine and form a stoma over the abdomen where external collection bags can be used. If not operated on, the localized high-grade nature will lead to rapid progression of the disease. If metastatic surgery will not help, then palliation is the target.

I hope this information helps you.

Feel free to ask further queries.

Thank you.